The Use of a Trabecular Metal Acetabular Component and Trabecular Metal Augment for Severe Acetabular Defects


      Stable acetabular fixation cannot be reliably achieved with the use of a hemispherical porous coated component alone in patients with a Paprosky type IIIa defect. The purpose of the present study was to determine the short-term results of a tantalum porous coated hemispherical acetabular component supported with a modular tantalum augment in Paprosky type IIIa defects. A total of 28 patients (28 hips) were treated for a type IIIa acetabular defect between 2001 and 2003 with the use of a trabecular metal acetabular component supported with a modular, superiorly placed trabecular metal augment. At an average of 3.1 years follow-up, 1 patient required rerevision for recurrent instability. The remaining hips remain radiographically stable. Clinically, the patients' modified Postel Merle d'Aubigne score improved from 6.8 preoperatively to 10.6 postoperatively. The use of a trabecular metal acetabular component with a superiorly placed trabecular metal augment demonstrates encouraging short-term results for Paprosky type IIIa acetabular defects.

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        • Weinstein
        Dartmouth atlas of musculoskeletal healthcare.
        AHA Press, Chicago (Ill)2001
        • Paprosky W.G.
        • Perona P.G.
        • Lawrence J.M.
        Acetabular defect classification and surgical reconstruction in revision arthroplasty. A 6-year follow-up evaluation.
        J Arthroplasty. 1994; 9: 33
        • Bradford M.S.
        • Paprosky W.G.
        Acetabular defect classification: a detailed radiographic approach.
        Semin Arthroplasty. 1995; 6: 76
        • Emerson Jr, R.H.
        • Head W.C.
        Dealing with the deficient acetabulum in revision hip arthroplasty: the importance of implant migration and use of the jumbo cup.
        Semin Arthroplasty. 1993; 4: 2
        • Johnston R.C.
        • Fitzgerald Jr, R.H.
        • Harris W.H.
        • et al.
        Clinical and radiographic evaluation of total hip replacement. A standard system of terminology for reporting results.
        J Bone Joint Surg Am. 1990; 72: 161
        • Morsi E.
        • Garbuz D.
        • Gross A.E.
        Revision total hip arthroplasty with shelf bulk allografts. A long-term follow-up study.
        J Arthroplasty. 1996; 11: 86
        • Woodgate I.G.
        • Saleh K.J.
        • Jaroszynski G.
        • et al.
        Minor column structural acetabular allografts in revision hip arthroplasty.
        Clin Orthop. 2000; : 75
        • Sporer S.M.
        • O'Rourke M.
        • Chong P.
        • et al.
        The use of structural distal femoral allografts for acetabular reconstruction. Average ten-year follow-up.
        J Bone Joint Surg Am. 2005; 87: 760
        • Goodman S.
        • Saastamoinen H.
        • Shasha N.
        • et al.
        Complications of ilioischial reconstruction rings in revision total hip arthroplasty.
        J Arthroplasty. 2004; 19: 436
        • Udomkiat P.
        • Dorr L.D.
        • Won Y.Y.
        • et al.
        Technical factors for success with metal ring acetabular reconstruction.
        J Arthroplasty. 2001; 16: 961
        • Chandler H.
        • Lopez C.
        • Murphy S.
        • et al.
        Acetabular reconstruction using structural grafts in total hip replacement: a 12 1/2 year follow-up.
        Semin Arthroplasty. 1995; 6: 118
        • Garbuz D.
        • Morsi E.
        • Gross A.E.
        Revision of the acetabular component of a total hip arthroplasty with a massive structural allograft. Study with a minimum five-year follow-up.
        J Bone Joint Surg Am. 1996; 78: 693
        • Unger A.S.
        • Lewis R.J.
        • Gruen T.
        Evaluation of a porous tantalum uncemented acetabular cup in revision total hip arthroplasty: clinical and radiological results of 60 hips.
        J Arthroplasty. 2005; 20: 1002
        • Nehme A.
        • Lewallen D.G.
        • Hanssen A.D.
        Modular porous metal augments for treatment of severe acetabular bone loss during revision hip arthroplasty.
        Clin Orthop Relat Res. 2004; : 201
        • Bobyn J.D.
        • Stackpool G.J.
        • Hacking S.A.
        • et al.
        Characteristics of bone ingrowth and interface mechanics of a new porous tantalum biomaterial.
        J Bone Joint Surg Br. 1999; 81: 907
        • Zhang Y.A.P.
        • Fitzpatrick D.C.
        • Heiner A.D.
        • et al.
        Interfacial frictional behavior: cancellous bone, cortical bone, and a novel porous tantalum biomaterial.
        J Musculoskelet Res. 1999; 3: 245